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1) If you were asked if you thought you were receiving the BEST possible care available for your pathology (illness), how would you answer?

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I don’t know if I am getting the BEST or most effective treatment for either my ADHD or my… malaise. I have not discussed an actual diagnosis with my T, so to avoid pretending to be an MD or Psychotherapist I will for go diagnosing myself and just call it “malaise with life”. Since this is my first experience with the mental health care system, I have no way to directly compare my treatment with others. What I can say is that I am not receiving poor or ineffective treatment for either condition.

Regarding my ADHD I have some serious concerns with the quality of care I am receiving for this condition. I would rate my therapist care in addressing my ADHD as FAIR. As for the care being provided by my neurologist, the 5 minute follow-up visits are a complete waste of time and money. I would have to rate this care as MARGINAL/POOR. My GP has shown much more interest in my specific responses to the medication, my perceptions on therapy, and the impact of these on my overall health. I would rate my GP’s role in caring for my ADHD as GOOD. I think I am responsible and actively involved in my own care. I read a lot about ADHD, monitor my response to the medication, and actively seek potential alternative/augmentative treatments. I rate the quality of my efforts as GOOD.

Regarding my “Malaise with life” condition, I judge my overall treatment quality to be GOOD. I have made significant progress and my therapist has repeated demonstrated her ability to provide meaningful insight to facilitate this progress. Unfortunately after 10 months of therapy, I sat on the ugly couch yet again last week and insisted that what I was feeling was wrong, abnormal, unjustified. I find it very alarming that I have still not grasped the basic concept that feelings and emotions are not right or wrong. This is knowledge is disheartening but simply where I am.

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2) What criteria do you think are important to consider when judging the quality of your overall mental health care? (pharmacology and psychotherapy) Look deeper than just whether you like or dislike your therapist-- Is just being licensed, nice, and a good listener enough to all it quality care?

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1. Improvement in symptoms. This includes not only perceiving myself as having improved; but actually demonstrating real improvement. I not only want to feel or perceive myself as being a better parent, I want to actually BE a better parent. I don’t want to just think I am more compassionate/empathetic, I want to ACT more compassionate/empathic

2. Efficient: I think quality care means that the treatment approach is effective and well matched with the individual. This to me means that measurable progress should occur in a timely manner. There should be a built in process for continually assessing the plan of care and making minor modifications to improve progress and identify problems.

3. Evidence –based: I think quality care should be consistent with credible standards and supported by evidence. I don’t think a good therapist haphazardly uses trial and error to find what works and what doesn’t. There should be some type of systematic (but flexible) way of determining a course of action.

4. Professionalism: Quality therapy is consistent with ethical practice guidelines, adheres to recognized professional standards, puts the patient’s needs and well-being above the needs of the therapist, business, insurance companies etc.

5. Collaborative: Therapy should be a collaborative effort between the patient and the therapist. Sometimes depending on the patient's mental state, the therapist may play a role in leading the course of treatment. Other times the patient should be empowered to direct the course of therapy.

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3) Do you have the same quality standards for your personal treatment as you do for others (i.e. your children or other family members)?

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For me this response is NO. I would never allow a family member to be place on a medication without being absolutely sure that 1) they were comprehensively evaluated and 2) properly followed using a systematic and logical assessment procedure for determining its effectiveness and proper dosage. Would I allow my children to be treated by my therapist? Yes, provided that she clearly stated her diagnosis, outlined treatment plan, and periodically reviewed their progress with me. My treatment is missing the diagnosis and general treatment outline. This leaves me feeling like I am progressing too slow, off on a tangent, or always wondering if I am going to hear… ’So are you sure you want another appointment?’ I understand the nature of my therapy may warrant this level of uncertainly, just on days like today I am craving a clear purpose and a way of measuring where I am in the overall process of achieving joy/happiness.